Litigation

The U.S. Department of Justice (DOJ) announced on April 20 that it has brought criminal charges against 18 defendants across the U.S. for various fraud schemes related to the COVID-19 pandemic. The DOJ seized more than $16 million in cash and other proceeds from the schemes, which resulted in more than $490 million in false…

The U.S. Department of Justice (DOJ) recently announced a settlement with a Missouri neurosurgeon and his fiancée regarding alleged violations of the False Claims Act (FCA) and Anti-Kickback Statute (AKS). The parties agreed to pay $825,000 to settle the case.

The neurosurgeon and his fiancée were accused of receiving impermissible kickbacks from spinal implant companies…

A law in New York Gov. Kathy Hochul’s proposed budget aimed at regulating “large physician practices being managed by entities that are investor-backed” has been dropped from the State Senate and Assembly proposed budgets (S4007B/A3007B).

Subject to final budget negotiations, the proposed law appears unlikely to be enacted in the immediate future. However, the proposal…

The Westchester District Attorney’s office announced on March 17 that it has charged Cesar Masso, a 78-year-old Queens resident, with illegally practicing dentistry without a license. Masso operated a dental practice in White Plains under the name East Post Dental, performing professional services including extractions, examinations, and delivering anesthetics, and has been charged with three…

Rivkin Radler’s Michael Sirignano authored an article for the March 2 issue of the New York Law Journal entitled “Healthcare Fraud Tops DOJ’s Annual False Claims Act Report – Again!” The article discussed a report issued by the U.S. Department of Justice detailing the settlements and judgments it obtained under the federal False…

A recent article in Part B News, “Be careful about upcoding; DOJ may come after it as a false claim,” discussed how the U.S. Department of Justice frequently prosecutes improper billing of CPT codes for Medicare patients. Rivkin Radler’s Jeff Kaiser was quoted in the article.

“Sometimes, a provider will upcode a…

The U.S. Department of Justice announced on February 27 that the University of Pittsburgh Medical Center (UPMC), James Luketich, its Chair of Cardiothoracic Surgery, and University of Pittsburgh Physicians have agreed to pay $8.5 million to settle a qui tam suit brought by a former UPMC cardiothoracic surgeon. The suit, brought under the False Claims…

On February 17, Daniel Russo, a Long Island resident, pleaded guilty in federal court in Brooklyn to multiple charges in connection with illegally distributing oxycodone. Russo faces decades in federal prison when he is sentenced.

Russo owned and operated Russo’s Pharmacy in Far Rockaway, Queens. From 2011 to 2014, he filled thousands of fraudulent prescriptions…

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced on February 2 that Banner Health, a not-for-profit hospital system based in Arizona, has paid $1.25 million in order to settle alleged HIPAA violations in connection with a cyber attack.

The incident occurred in 2016 when a hacker gained access to…